Will Oud is a Research Assistant in Behavioural Neurology for the Brain Health Clinics, Rotman Research Institute, Baycrest (Toronto, ON).

Forecasting Canadaâ€™s
Brain Health & Dementia Risk

A decade into the new millennium and it is well understood that Canadaâ€™s demographic landscape is changing â€“ our most elderly population cohort is growing immensely. Advances in science, healthcare technology and medicine, along with better lifestyle choices, have resulted in individuals living longer lives and maintaining better physical health throughout their later years. Along with this will come the inevitable implications of an older population.

An impressive study recently commissioned by the Alzheimerâ€™s Society of Canada â€“ appropriately titled, â€śRising Tideâ€ť â€“ examines the impending tsunami-like impact of dementia on Canadian society. The studyâ€™s results are truly alarming. It estimates that about 500,000 Canadians are living with dementia today, already crowning it as the most significant cause of disability in those aged 65 and over. This number is expected to more than double in the next 30 years, increasing the number of those inflicted to 1,125,200 people by 2038. Such a dramatic increase represents not only a serious health concern but also a crippling economic burden for Canadian society. It is clear that we must begin addressing the issue now.

What Brain Health Means to You and I

Many of us will come to accept that living into our 70â€™s, 80â€™s, 90â€™s or beyond will eventually mean sacrificing some of our physical independence due to unpreventable physical frailty. We may need to employ services like homecare for the added assistance required in maintaining a certain level of personal independence. While for most this is an acceptable compromise in exchange for an extended lifespan, amongst our biggest unresolved fears and one most difficult to comprehend is the potential loss of our mental faculties.

Losing the ability to think for ourselves, to decide on the direction of our own lives as a result of the senility caused by a degraded brain, is not a comfortable concept even for the most stout of heart. For anyone who has witnessed the devastating effects of dementia on another â€“ whether in a family member, friend, or as in my case with clients â€“ the experience can become a very potent alarm, signalling the importance of educating ourselves of this health risk.

I welcome you to my Brain Health Series on the Premier Homecare Services Blog. I hope that with this first entry you will become convinced we should all begin paying more attention to this topic of brain health.

Shattering Traditional Modes
of Thinking about the Brain

In the not so distant past, the accepted concept of the adult nervous system was that it was a fixed static entity both in terms of function and structure. Remember hearing the expression, â€śYou canâ€™t teach an old dog new tricksâ€ť? Contrary to this ingrained maxim, many years of groundbreaking research â€“ the work of many brilliant minds â€“ has begun to offer a different way of thinking about the brain. We now view the brain as a very dynamic organ constantly changing both in function and in structure.

Evidence of Functional Change (Synaptic Plasticity)

Back in the middle of the 20th century, neuropsychologist Donald Hebb posited a theory, which has been summarized as, â€ś[brain] cells that fire together, wire togetherâ€ť. This means that if a neuron (the cells which make up our nervous system and act by stimulating each other in a pathway) continually causes a neighboring neuron to fire, a metabolic change will take place that can, over time, strengthen the connection between the two. Neuroscientists like Michael Merzenich have applied this theory and observed significant functional rewiring of the cortex of primate and human brains, experimentally demonstrating that this theorized functional change occurs.

Evidence of Structural Change (Neurogenesis)

We used to think that the growth of new neurons was not possible after our childhood years. If someone were to experience brain injury there wasnâ€™t much that could be done with them other than to help them cope with what functions remained because we believed that brain cells could not regenerate and the damage was permanent. We now know that through a process called neurogenesis, the development of new neurons is very much a possibility. Psychologist Elizabeth Gould has conducted pioneering research in this area of neuroscience. She has shown that the generation of neurons in the adult brains of monkeys does indeed occur. These newly created neurons arise from neural stem cells and migrate not only to the hippocampus â€“ a part of the brain important for memory â€“ but to the associative areas of the cortex that are important for higher cognitive function.

Until recently and most likely because of the traditional model of the static brain, the most focus on brain health has been given to the stages of older age and what happens in advanced brain failure like Alzheimerâ€™s disease. Armed with this fresh knowledge regarding a more dynamic brain, we may begin to adopt a more holistic approach to brain health and focus on the greater process of brain aging. By turning our attention to what we can do in the areas of prevention, early intervention, and rehabilitation, we may be able to strengthen Canadaâ€™s brain health and reduce the burden of dementia on future generations.

Many scientists are actively searching for effective methods of promoting positive changes in our brains. The hope is to find solutions for preventing or slowing the loss of brain tissue during aging and disease progression, or for minimizing the impact of such losses. Much of the research that has shown noteworthy promise is in healthy lifestyle choices like physical activity, nutrition, the exercise of mental activity, and choice of environment. According to the Alzheimerâ€™s Society, promoting brain health through lifestyle choices may be the most effective way of reducing the risk of Alzheimerâ€™s disease and for slowing down its progression.

Through this blog series â€“ Brain Health by Will Oud â€“ I will take a critical look at contemporary research involving lifestyle choices and their potential effects on healthy brain aging and the prevention of disease. Iâ€™ll begin to sift through what advice is supported by valid research and what claims the literature just doesnâ€™t back up. Follow-up four weeks from now for the next addition to the series.

For an interesting look at the research thatâ€™s being conducted in neural plasticity and some remarkable stories of the individuals who have benefited, I suggest Norman Doidgeâ€™s book â€śThe Brain that Changes Itselfâ€ť. It is also a â€śNature of Thingsâ€ť CBC documentary: http://www.cbc.ca/video/#/Shows/The_Nature_of_Things/ID=1233752028

Great information. I donâ€™t think anyone looks forward to the days where they will start having trouble remembering a lot. Good luck to all the scientists in the future looking for ways to increase brain health.